Lilly Balks At Higher Rebates In Mental Health Bill
24 CommentsBy Ed Silverman // March 5th, 2008 // 4:43 pm
The drugmaker says a bill that would revamp coverage for mental health is a good thing, with one exception - higher rebates it says are called for in HR 1424. The increase to 20.1 percent from 15.1 percent “would limit Medicaid beneficiaries’ access to medicines, including mental health medications,” the drugmaker claims, adding that its position is supported by a leading mental health advocacy group and Congressional Budget Office data.
“At first blush, increasing the Medicaid rebate appears an alluring target for the federal government to pay for parity, but the harsh irony is that such an action could lead to even greater disparities in Medicaid patients’ future access to medications,” says Sonya Sotak, a Lilly lobbyist says in a statement. “The Medicaid rebate is a price control, which time and again has been shown to harm innovation, the U.S. economy, and ultimately public health.”
The statement goes on to say that the National Council for Community Behavioral Healthcare wrote a letter to Congress last week, echoing its concerns. “I fear that increasing the pharmaceutical rebate in Medicaid could have the unintended consequence of reducing access to necessary medications for thousands of Americans. I urge you to find another way to pay for the provisions of HR 1424,” wrote NCCBH ceo Linda Rosenberg.
Here’s something Lilly’s statement doesn’t say: the National Council for Community Behavioral Healthcare receives support from numerous drugmakers, including Lilly, according to the most recent annual report on its web site (see the second-to-last page). Lilly also is a sponsor of its conference.
Bob Freeman
If companies promote drugs for mental illnesses to the public, then the government, acting in behalf of the public, has the perogative to impose higher rebates. As I noted in my Pharmalot Op-Ed, taxing promotional spend is in the public’s interest.
Lisa Van S
How about a Rebate for New Jersey Tax Payers!!! Since we foot the the bill,..while Lilly and others rcve billions in Profits,..Give me a Break.
Lisa Van S
This is the Kennedy Bill…. I say if he wants this so bad ,then He should dig into his own trust fund to pay for it!!!!
Bob Freeman
Lisa Van S. It probably makes more sense for States to use supplemental rebates instead of hoping for Congress to act. Even though NJ is the home of many pharmas, the excesses in this drug category deserve remedy.
Matt
I find it difficult to believe that Lilly really cares about the medicaid recipients. It just boils down to profits for Lilly, they’re the last people to actually care about the health of the patients who eat their drugs.
Lisa Van S
Bob Freeman,
I agree!..
Bob Freeman
Thanks, Lisa Van S. I recognize that taxing DTC ads is problematic but I think a higher supplemental rebate on CNS drugs advertising on TV and in print is also worth considering.
The corrupting influence of pharma money on patient/disease advocacy groups is a growing concern and should be subject to disclosure.
M Helm, MD
In my experience, Lilly does not believe in supplemental rebates. They will (grudgingly) pay the CMS mandated rebate, but they will come up with every imaginable (imaginary) reason not give a supplemental Medicaid rebate. I’m told by a Lilly Govt/Managed Care manager that this is “corporate policy.” They would rather sponsor legislation to remove the categories in which they compete from ordinary pharmacy benefit management tools. This has been a successful strategy in some states.
Lisa Van S
Bob Freeman,
If you find time,.Please listen to the NJ hearing on Informed consent on Psychotropics that carry a black box. The psychiatrist from APA, who treats over 150 medicaid children who was is a huge subscriber of antipsychotics in children as young as 5 for ADD/ADHD had some difficult question to answer. A378 was the last bill heard
http://www.njleg.state.nj.us/media/archive_audio2.asp?key=ACO&session=2008
Bob Freeman
Dr. Helm, that info matches my understanding also. My recollection is that manufactuers of atypical antipsychotic drugs are extremely reluctant to pay supplemental rebates. I’m not that familiar with the SSRI market.
Some company, however, will eventually “buy” the business in this category by not only accepting higher rebates but also exceeding them. Generic competition may force this at some point. The real problem, of course, is that pharma got its way and got legislation to cover all of these drugs under Medicare Part D.
Bob Freeman
Lisa Van S, I promise that I will. I have several students in my pharmaco-epidemiology class that are looking into safety issues of SSRIs (many other drugs and drug classes are being evaluated also), and I’ll have them listen. The entire issue of drug safety has been an eye-opener for first year pharmacy students.
Lisa Van S
Bob Freeman
My nephew just graduated, and rcved his short coat in January, he jokes about Pharmacy students. So, I will make sure he sees this post. My daughter has abandoned her Criminal Justice career, for Medicine. Needless to say, Mom is happy. Couldnt imagine her being a NJ State Trooper!!!
I Love To travel, Id love to speak to your students, at my own expense of course. I have an image to uphold!!!
Laurie
bob, the A378 hearing stats at one hour and one minute into that audio
Atlex
Bob Freeman, your are not correct regarding Part D. Part D legislation does not mandate coverage of antipsychotics. A CMS regulation requires inclusion on all Part D formularies. However, this reg does not include unrestricted access. Part D plans can and do put prior authorization requirements and other restrictions on these drugs.
Bob Freeman
Lisa Van S, let me look into possibilities for bringing you down where we can cover your expenses. You should be proud of your daughter and nephew. our students are politically aware and we like to bring in special speakers from outside TX.
I can be reached at freeman@pharmacy.tamhsc.edu (Texas A & M Health Science Center, College of Pharmacy). I don’t worry about my identity since I believe in disclosure.
Laurie, thanks for the location of the testimony on the audio. Very helpful.
Bob F.
Bob Freeman
Atlex, you are correct in that access is not unfettered although they have to be included. I am aware that restrictions can be placed including cost-sharing. I try to avoid being pedantic and should have, in this case, added the qualifying comments.
Lisa Van S
Bob Freeman,
If you dont mind, Id prefer to pay my own expenses. I also have family and friends living in Texas.
My Identity,.. All to see, I guess.
Bob Freeman
Understood, Lisa. Contact me at your leisure. We are interviewing candidates for the Fall class and I’m tied up the next two days.
Donna
Lisa,
You also have a god daughter starting her nursing classes this fall after two year’s of pre nursing course’s, and am proud to say that she will go into her career knowing alot more then her fellow student’s thank’s to you,and our dinner conversation’s I’m sure she will make an excellent nurse….she will already know more going in then they teach in school….
Ken Thomas, RN
Donna and Lisa,
Regarding Nurses training: Unfortunately we nurses have not gotten to the point where we will question big pharma or psychiatry about their practices. For the most part, nurses who “see the light” and are opposed to this calamity are rare. There is much opposition in viewpoints counter to the “lock step” we have in the medical profession. But let them know that there are some of us who will fight for our patients right to a clear mind and drug-free rehabilitation. http://www.ipetitions.com/petition/NrseCall2Arms/
Ken
Laurie
Ken, you are so right! Just read any website for psych nurses and you will see NO mention of problems with any of the drugs that they administer, and if you point out FDA warnings you are shouted down. Very sad.
Justice in Michigan
Just on the topic of teaching, I have had several Nursing students in my course on ethics, policy, and pharma - they have all been excellent. What’s great about the course is that I also get students from pharm, engineering, business, arts/sciences, etc. etc. - 30 different majors represented last time.
This topic requires all of them. And, as Bob also reports, it is an amazing thing to see how eye-opening courses like this can be. Teaching at its most gratifying.
(We also bring in a number of docs, pharmacologists, industry people, consumer activists, etc..)
Laurie
Justice..you are doing what a good teacher does! Having students see beyond the obvious makes a great practitioner!
Lisa Van S
Im sure if they get charged w/Manslaughter,.. Maybe then they will begin to see the light!!